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The NHS in England is halfway through its tightest ever decade of funding growth. If plans set out in the spending review last autumn hold true to 2020, real term growth in the NHS will average around 1% a year over this decade—relative to the long term average of just under 4%. This is equivalent to just 0.3% growth in spending per head of population.

The pips are squeaking. In 2015-16, NHS provider organisations were £2.8bn (€3.32bn; $3.69bn) in the red, with more than two thirds of NHS trusts not balancing their books. Recently published accounts show the Department of Health overspent the total health budget (excluding capital) by £207m.1 This is despite the fact that growth in health spending was “frontloaded”—higher allocations in 2015-16 and 2016-17 before dropping from 2017-18 to 2020-21.2 “Brexit” could introduce additional risks to even this historically low rate of funding increase. Uncertainty after the EU referendum has threatened the stability …